Tourette Syndrome Major Issues - Research Paper Example

Tourette Syndrome Affiliation History of Tourette syndrome Tourette syndrome is a hereditary neurological complication that starts at childhood. It is characterized by the presence of several physical tics and one vocal tics. The person who discovered the diseases is called Jean-Martin Charcot. The discovery was done between 1825 and 1893. The possibility movement done in 1918-1926 led to several epidemic of tic disorder. Further research done in 1972 indicated that Tourettes is a neurological disorder rather than a psychological disorder. In 1990, there were existed new views of Tourettes emergence in which adverse environmental and biological vulnerability are the key factors that catalyze the disorder. Research and findings in 1999 have advanced Tourette syndrome in areas like the neuropathology, neurophysiology, and neuroimaging (Goodman & Alterman, 2012). Tic disorder has been a subject under discussion and speculation for at least the past 200 years. Despite the evolving nature of technology and advanced clinical tests, the nature of tic disorder remains a challenge. Notions are there trying to define the causes of TS ranging from irritation of the motor neural systems to hereditary degeneration. Unsurprisingly, each of the above aetiological explanation has come up with a new treatment of the disorder. The cardinal features of Tourette’s syndrome are phonic and motor that wax and win in severity of the disorder. Motor tics begin at the age of 3 and 8 years with transit period of eye blinking or other facial tics (Frey et al., 2010). Phonic tics, such as bouts of sniffing and throat clearing are also evident. The most severe cases of Tourette’s syndrome is reported in adulthood. Epigenetic Causes of Tourette’s syndrome Genes Genetic studies have so far indicated that families and twins offer compelling evidence that genetic factors are drawn in vertical transmission in households with Tourette’s syndrome and other related disorders. Currently, the nature of vulnerability of gene that prompts people to widen the disorder are still unknown. It can be stipulated that many genes have a role. Non- parametric approaches with families with several siblings affected with TS has been undertaken. The sib-pair approach is appropriate for diseases with indistinct mode of transmission and has been working well with sophisticated disorders, such as diabetes mellitus and hypertension. In one of the studies, of TS, two areas were reported to be linking, one a chromosome 4q and another one is chromosome 8p. A quantitative phenotype of was conducted using sib-pair methods and indicated that siblings share TS symptoms for hoarding phenotypes for markers at 4q34–35, 5q35, and 17q25, a proximity to area linked to Tourette’s syndrome. Another gene approach used to determine the causes of TS is identity by descent approach. This approach was done in populations in Costa Rica and South Africa. The approaches perception is that a few people called founder individuals contribute the vulnerable genes that are distributed within a larger population. The South African research indicated that regions near to the centromere of chromosome 2 and on 6p and 11q, the marker of French-Canadian family were allied to higher LOD scores. The same marker with similar linkage disequilibrium with TS regions was noticed in South African population. However, none of the chromosomal regions with cytogenetic abnormalities has been found to co-segregate with TS phenotypes thus, lacks convincing evidence of linkage in regions with higher density. Several candidate genes has so far been assessed in people with TS, including various dopamine receptors (DRD4 and DRD5), noradrenergic genes (ADRA2C and DBH) and dopamine transporter and other serotonergic genes (4HTT). Genetic differences at one of the above loci are improbable the main source of vulnerability to TS disorder, but they could have a cumulative effect. Environment It has been proved that males are more affected with TS as compared to their female counterparts. Despite the fact that this association could only be attributed to genetic mechanisms, frequent male’s transmissions seem to dominate the charisma of X-linked susceptibility gene. This observation led to the development of the hypothesis that androgenic steroids during fetal development have a role in TS. Because of this, investigators are on board testing the effectiveness of antiandrogenic medication in the management of refractory tics. Tic disorders are noted to be stress sensitive problems. Its symptoms are evident during stressful events. The events must be adverse in nature to trigger emotional sensitivity. Such events include vacation trips, birthdays, and the start of school. Stress related neurotransmitters are known to cause Tourette’s syndrome. For example, compared to other health controls patients with TS disorder excrete substantially more norepinephrine in 15 hours lead to lumber puncture. This raises the concentration of corticotropin releasing and norepinephrine; a conducive environment for Tourette’s syndrome to manifest. Findings have indicated that subset patients with TS are exemplified by heightened reactivity of hypothalamic-pituitary adrenal and sympathetic systems. Other less abundant cell types have a key role in this form of habit learning, including cholinergic fast spiking interneuron and active neurons. Tonically active neurons and very sensitive to perceptual cues since they signal the network within the boundaries of cortico-basal learning circuits. They are very responsive to dopaminergic inputs participating in perceived salience. With this TS disorder gets a conducive spring to inhabit and cause negative effects to the victims (Leckman et al., 2013). Symptoms of Tourette’s syndrome and Treatment Symptoms Tics is categorized as either complex or simple. Simple tics are brief, sudden and have repetitive movements that entail limited number of muscles. Some of the simple tics of Tourette’s syndrome include eye movements, shoulder shrugging, sniffing, grunting sounds, and facial grimacing. Complex tics are evident, arranged patterns of movements linking several muscles. Such motor tics might include head twist combined with facial grimacing and shoulder shrug. Other symptoms of complex tics are fixed including touching objects, sniffing, jumping, hopping, and twisting. Complex vocal tics include phrases and words. Treatment Cognitive Behavioural Therapy It is based on an existing relationship between feelings, behaviour and thoughts of an individual suffering from Tourette’s syndrome. The patient or individual is encouraged to take part in the intense programme that may involve twenty hours of participant treatment. The programme involves re-evaluation of the individuals thinking, beliefs in relation to the targeted symptoms. The patients monitor their own behaviors, reasoning and feelings, relating them to the present or past symptoms. They are also encouraged to develop alternative options of coping with the identified symptoms. This results into stress reduction and improves the functioning of the individual. This approach has been widely accepted by patients and in many cases, has shown to improve their mental condition. Family Treatments These are used as supplements to other treatments to provide the participant with confidence, and calmness during the process of treatment by reducing stress (Pilitsis & Bakay, 2011). It entails administering of education on Tourette’s syndrome and skills on problem solving. The treatment aims at: reducing emotional conflict and burden on the family; increase of family ability to anticipate and act on problems that arise; making the family has realistic and reasonable expectations on the patient’s performance; and many more. Family treatments have shown an efficiency in numerous cases by reducing relapse and hospital admission when implemented early in the treatment. Art Therapy It involves complex processes that combine psychotherapeutic methods that encourage patients to express themselves via art. This focuses on a variety of methods or techniques that develop a working therapeutic relationship where emotions are processed and expressed through art. Since most patients with Tourette’s syndrome have problems with speech utterances, art is an alternative way of communication, which requires specialized medical personnel to understand and come up with meaning. Adherence Therapy This is the provision of patients with support, management strategies, and information in order to improve their adherence or acceptance to medication. Adherence therapy aims at enhancing the patient’s attitude towards medicine and treatment acceptance hence, improve their clinical results while preventing future relapses in the process (Murphy, 2010). A session of this therapy may run for thirty minutes to an hour per session and constitutes four to eight sessions. It is an important treatment in the treatment process and should be tailored to the patient’s needs. Evaluation It is evident that Tourette’s syndrome is a neurological condition that had affected man for so long. People have been extremely ignorant about this condition. It took many years of research for physicians to understand what exactly Tourette’s syndrome was. The patient in this essay suffered from Tourette’s syndrome and many factors could have been the cause of the patient’s condition. Environmental factors are the most likely causes of this condition since no one in his lineage had been diagnosed with such a condition. A comprehensive assessment approach was used to examine the patient before a conclusion that he suffered from TS was made. Various treatments were used to try to restore the patient. Antipsychotic drugs were used to try to restore the patient’s condition. However, drugs are less effective in the treatment of such mental disorders. Various rehabilitation mechanisms were applied to try to restore the patient. The patient became involved in many other activities such as games and sports. With these treatments, we have witnessed a remarkable improvement of by the patient, but he is still under surveillance. References Goodman, W. K., & Alterman, R. L. (2012). Deep brain stimulation for intractable psychiatric disorders. Annual review of medicine, 63, 511-524. Mink, J. W., Walkup, J., Frey, K. A., Como, P., Cath, D., DeLong, M. R., ... & Vitek, J. L. (2012). Patient selection and assessment recommendations for deep brain stimulation in Tourette syndrome. Movement disorders, 21(11), 1831-1838. Motlagh, M. G., Smith, M. E., Landeros-Weisenberger, A., Kobets, A. J., King, R. A., Miravite, J., ... & Leckman, J. F. (2013). Lessons Learned from Open-label Deep Brain Stimulation for Tourette Syndrome: Eight Cases over 7 Years.Tremor and Other Hyperkinetic Movements, 3. Okun, M. S., Fernandez, H. H., Foote, K. D., Murphy, T. K., & Goodman, W. K. (2010). Avoiding deep brain stimulation failures in Tourette syndrome. Journal of Neurology, Neurosurgery & Psychiatry, 79(2), 111-112. Pilitsis, J. G., & Bakay, R. A. (2011). Deep brain stimulation for psychiatric disorders. Psychopharm Review, 42(9), 67-74. Read More